Changes in dental fear among Finnish adults: a national survey

Objectives: The aim of this study was to evaluate changes in dental fear among adult Finns aged 19 years and over at the beginning of the study in 2000 &ndash; 2011 in a nationally representative sample. Methods:&nbsp; The study was based on Health 2000 and 2011 Surveys by the National Institute for Health and Welfare in Finland. The Health 2000 survey used a stratified two-stage cluster sampling design (N=9,922). Those who participated in 2000 (n=7,964) were invited to participate in 2011. The number of participants was 3,961. Dental fear was assessed by a single question: &rdquo;How afraid are you of visiting a dentist?&rdquo; (not at all, somewhat, very much). Background variables included were age (categories 30-34, 35-39, 40-44, 45-54, 55-64, 65-74, 75+ years), gender, marital status (non-single, single) and education (basic, secondary, higher). To match the population sizes in different areas and thus forming a nationally representative data, the data were weighted based on age, gender and area.&nbsp; General linear modelling for repeated measures was used to evaluate changes in dental fear and associations with background variables. Results: Between 2000 and 2011 dental fear decreased more often than increased among adults in Finland. Change from being very afraid to not at all afraid of visiting a dentist was most common in the oldest group. For most participants, dental fear remained stable; being very afraid of visiting a dentist was more stable among participants from 35 to 54 years of age than among younger or older participants. Conclusions: Dental fear is still common among adults Finns and it seems to depend on age. As the most obvious consequence of dental fear is avoidance of dental care, reducing dental fear should be taken into account when planning and reorienting oral health care services.</p

Clinical Study Comparing Health Promotion Programs in Public Dental Service of Vantaa, Finland: A Clinical Trial in 6-36-Month-Old Children

Objective. The study assessed whether the new family-based programs in health promotion or the training of dental professionals had an impact on the colonization of mutans streptococci (MS) in young children. Material and Methods. The participants were children born in 2008 and inhabitants of Vantaa aged 24-36 months. The families with first-born children were invited to a questionnaire study. Vantaa was categorized into three matching areas, which were randomly assigned to different programs. New counseling methods were trained. The routine program used earlier served as the control group. The children born in 2006 served as a historic control. The outcome measure was the presence of MS. Statistical method was logistic regression. Results. Colonization of MS was found only in few children born in 2006 or 2008; 15% and 11%, respectively. Within the 2008 birth cohort, the addition of parental counseling did not improve the routine program. Instead, the father&apos;s advanced level of education ( = 0.044) and the child&apos;s reported the use of xylitol at least three times a day ( = 0.014) associated with negative MS scores. Conclusions. The routine program and training of the professionals seem to reduce the proportion of children with MS more than adding parental self-care to oral health programs

Comparing Health Promotion Programs in Public Dental Service of Vantaa, Finland: A Clinical Trial in 6–36-Month-Old Children

Objective. The study assessed whether the new family-based programs in health promotion or the training of dental professionals had an impact on the colonization of mutans streptococci (MS) in young children. Material and Methods. The participants were children born in 2008 and inhabitants of Vantaa aged 24–36 months. The families with first-born children were invited to a questionnaire study. Vantaa was categorized into three matching areas, which were randomly assigned to different programs. New counseling methods were trained. The routine program used earlier served as the control group. The children born in 2006 served as a historic control. The outcome measure was the presence of MS. Statistical method was logistic regression. Results. Colonization of MS was found only in few children born in 2006 or 2008; 15% and 11%, respectively. Within the 2008 birth cohort, the addition of parental counseling did not improve the routine program. Instead, the father’s advanced level of education () and the child’s reported the use of xylitol at least three times a day () associated with negative MS scores. Conclusions. The routine program and training of the professionals seem to reduce the proportion of children with MS more than adding parental self-care to oral health programs

Dental students’ and patients’ perceived importance and knowledge of dental anxiety

Abstract Aim: To examine the perceived importance and knowledge of the dental students’ in their treatment of dental anxiety according to their year of study and to find out patients’ perceived importance of the dental students’ knowledge of dental anxiety according to their level on dental fear. Methods: Dental students (N = 219) at the University of Turku and non‐probability convenience sample of 100 of patients attending the Dental Teaching Clinic were given questionnaires with multiple choice and open‐ended questions. Students were categorised into three groups according to the year of study (1–3, 4, 5). Patients were categorised into three groups using the established cut points for Modified Dental Anxiety Scale (no fear = 5–9, low fear = 10–18, high fear = 19–25). The differences between groups were evaluated using cross‐tabulations, chi squared and Fisher’s exact tests. The open‐ended questions were subjected to content analysis. Results: Students’ perceived importance of dental anxiety did not differ between three groups. Students with greater undergraduate education and clinical experience were more likely to have excellent or quite good knowledge (P &lt; 0.001). Patients’ perceived importance of dental students’ knowledge of dental anxiety was greater in patients with high level of fear. The overlapping category that emerged from the open‐ended question analysis was communication skills. This appeared to be important for patients with dental anxiety and for dental students in their management of dental anxiety. Conclusion: Clinical communication skills should be part of dental anxiety management teaching. Dental students should be able to gain sufficient knowledge and skills in treating dental anxiety before graduating

Clinical evaluation of fiber-reinforced composite restorations in posterior teeth - results of 2.5 year follow-up

Objectives: The aim of this study was to evaluate the clinical performance of posterior composite restorations reinforced by bulk base of short-fiber composite (everX Posterior, GC Corporation). Methods: 36 short fiber-reinforced composite restorations were placed in premolar and molar teeth of 33 patients. Eight of the teeth were vital and 28 non-vital.  Average follow up time of the restorations was 30.6 months (2.5 years), ranging from 16.2 to 51.3 months (1.3 - 4.3 years). Results: One restoration failed during the follow-up period due to secondary caries, at time point 39.5 months. Three fillings had minor fractures during the follow-up. Overall survival rate of the restorations was 97.2 % and success rate (no maintenance needed) 88.9 % respectively. Conclusion: Posterior composite restorations with bulk base of short-fiber composite showed good clinical performance in the short term evaluation. </p

Parent's self-reported tooth brushing and use of fluoridated toothpaste: Associations with their one-year-old child's preventive oral health behaviour

Objective The aim of the study was to examine if the tooth brushing frequency and use of fluoridated toothpaste of the mother and father were associated with the tooth brushing frequency and use of fluoridated toothpaste for their 1-year-old child. Methods This cross-sectional study is part of the FinnBrain Birth Cohort Study. Questionnaire data were obtained from 1672 mothers and 867 fathers on tooth brushing and use of fluoridated toothpaste, age, education, number of siblings and parity (when the child was 1-year-old). For 763 families (mother and father), data from both parents were available. Tooth brushing was dichotomized to at least twice daily (2× day) and less than 2× day, and use of fluoridated toothpaste for child to at least once daily and less than once daily. The association between brushing of child's teeth (both parents less than 2× day) and use of fluoridated toothpaste for the child (both parents less than once daily) with parent's own tooth brushing was modelled with logistic regression analyses adjusted for family-related variables (parents' age and education, number of older siblings) using odds ratios (OR) and 95% confidence intervals (CI). Results Families in which both parents brushed their own teeth less than 2× day were more likely to brush their child's teeth less than 2× day than families in which both parents brushed their own teeth 2× day (OR = 9.23; 95%CI = 5.42–15.69). The likelihood of not brushing the child's teeth 2× day was less strong when at least one of the parents brushed his/her own teeth 2× day (mother 2× day: OR = 1.97; 95%CI = 1.25–3.10; father 2× day: OR = 2.85; 95%CI = 1.51–5.40). Conclusions Less frequent tooth brushing of both mothers and fathers was strongly associated with less frequent tooth brushing of their child. When educating parents on child oral home care, parents' own home care and inclusion of fathers also need more attention.publishedVersio

The reproduction of gender differences in early career choices and professional identity of young dentist in Finland

Introduction For over the last 20 years, approximately 70% of working dentists in Finland have been women. However, there is internal division of the profession along gender lines. Female dentists work more often in the public sector and male dentists in the private sector. The aim of this study was to investigate the gender differences in young dentists' early career choices, specialization plans, values and perceptions of professional identity. Materials and methods The data were taken from a national e-mail questionnaire study called "Young Dentist," which was sent to 458 dentists who had received their licence to practise dentistry in 2014-2016 from all four universities with dental curricula in Finland. A total of 52% young dentists (n = 238) answered the questionnaire. Results and discussion The results indicated that whereas female dentists were more likely to perceive themselves as comforters, social workers and health promoters, male dentists tended to perceive themselves as technicians. These professional identities were interrelated with early-stage career choices in which female dentists worked more often in the public than in the private sector when compared to male dentists. There were also clear gender differences in the importance of values and the specialization plans of the young dentists. Conclusion Young dentists in Finland make career choices and develop professional identity in accordance with the attributes traditionally associated with cultural ideals related to femininity and masculinity.Peer reviewe

Association of depression and anxiety with different aspects of dental anxiety in pregnant mothers and their partners

Funding: Academy of Finland and Signe and Ane Gyllenberg Foundation.Objectives The aim was to confirm the factor structure of Modified Dental Anxiety Scale (MDAS) and to investigate whether the association of these factors with general anxiety and depression varied across gender. Methods The FinnBrain Birth Cohort Study (www.finnbrain.fi) data from the first collection point at gestational week 14 were used. Of the invited participants (n = 5790), 3808 (66%) expectant mothers and 2623 fathers or other partners of the mother agreed to participate, and 3095 (81.3%) mothers and 2011 (76.7%) fathers returned the self‐report questionnaire. Dental anxiety was measured with the MDAS, general anxiety symptoms with Symptom Checklist‐90 (anxiety subscale) and depressive symptoms with the Edinburgh Postnatal Depression Scale. Multiple group confirmatory factor analysis (MGCFA) was conducted to test the equivalence of the factor structure and multiple group SEM (MGSEM) to test the configural invariance (unconstrained model) and metric invariance (structural weights model), across genders. Results Of those consenting, 3022 (98%) women and 1935 (96%) men answered the MDAS. The MGCFA indicated good convergent validity for the two‐factor model for MDAS, but somewhat low discriminant validity (factors demonstrated 72% shared variance). The MDAS items loaded clearly higher for the assigned factor than to the other factor (differences in loadings >0.2), indicating that the 2‐factor model has merit. According to the final MGSEM model, anxiety symptoms were directly related to anticipatory dental anxiety, but not to treatment‐related dental anxiety. Conclusions When assessing dental anxiety with MDAS, considering also its two factors may help clinicians in understanding the nature of patient's dental anxiety.PostprintPeer reviewe

Changes and determinants of unmet oral health treatment need

Objectives Our aim was to describe the nature and determinants of the changes in unmet treatment need between the years 2000 and 2011 after a major oral healthcare reform and a wider supply of subsidized care.Methods The study used a longitudinal sample (n = 3838) of adults who had participated in both the Health 2000 and 2011 surveys (BRIF 8901). Those reporting self-assessed treatment need without having visited a dentist in the previous 12 months were categorized as having unmet treatment need. Two logistic regression models were applied to determine the effects of predisposing and enabling factors on change in unmet treatment need. Model 1 was conducted among those who reported unmet treatment need in 2000 and evaluated the determinants for improvement. Model 2 was conducted among those who did not have unmet treatment need in 2000 to evaluate the risk factors for having unmet treatment need by 2011.Results Unmet treatment need was reported by 25% of the participants in 2000 and by 20% in 2011. Those with unmet treatment need in 2000 were less likely to report improvement by 2011 if they had poor subjective oral health, basic or intermediate education level, or poor perceived economic situation in 2000. Those who did not have unmet treatment need in 2000 were more likely to have it in 2011 if they were males or from northern Finland and less likely to if they came from central Finland or were older.Conclusions The wider supply of subsidized oral health care during the study years did not lead to complete elimination of treatment need. The determinants of unmet treatment need, such as low or intermediate education level and perceived economic difficulties, should be used in targeting the services at those with treatment need to achieve better oral health outcomes.</div